Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Anyone who reads this blog knows that many physicians still aren’t convinced that the big industry-wide EMR rollout was a good idea. But nonetheless, I was still surprised to learn — as you might be as well — that in the aggregate, physicians thoroughly dislike pretty much all of the ambulatory EMRs commonly used in medical practices today.

This conclusion, along with several other interesting factoids, comes from a new report from healthcare research firm peer60. The report is based on a survey from the firm conducted in August of this year, reaching out to 1,053 doctors in various specialties.

Generally speaking, the peer60 study found that EMR market for acute care facilities is consolidating quickly, and that Epic continues to add market share in the ambulatory EMR market (Although, it’s possible that’s also survey bias). In fact, 50% of respondents reported using an Epic system, followed by 21% Cerner, 9% Allscripts and 4% the military EMR VistA. Not surprisingly, respondents reporting Epic use accounted for 55% of hospitals with 751+ beds, but less predictably, a full 59% of hospitals of up to 300 beds were Epic shops as well. (For an alternate look at acute care EMR market share, check out the stats on systems with the highest number of certified users.)

When it came to which EMR the physician used in their own practice, however, the market looks a lot tighter. While 18% of respondents said they used Epic, 7% reported using Allscripts, 6% eClinicalWorks, 5% Cerner, 4% athenahealth, e-MDs and NextGen, 3% Greenway and Practice Fusion and 2% GE Healthcare. Clearly, have remained open to a far greater set of choices than hospitals. And that competition is likely to remain robust, as few practices seem to be willing to change to competitor systems — in fact, only 9% said they were interested in switching at present.

To me, where the report got particularly interesting was when peer60 offered data on the “net promoter scores” for some of the top vendors. The net promoter score method it uses is simple: it subtracts the percent of physicians who wouldn’t recommend an EMR from the percent who would recommend that EMR to get a number from 100 to -100. And obviously, if lots of physicians reported that they wouldn’t recommend a product the NPS fell into the negative.

While the report declines to name which NPS is associated with which vendor, it’s clear that virtually none have anything to write home about here. All but one of the NPS ratings were below zero, and one was rated at a nasty -73. The best NPS among the ambulatory care vendors was a 5, which as I read it suggests that either physicians feel they can tolerate it or simply believe the rest of the crop of competitors are even worse.

Clearly, something is out of order across the entire ambulatory EMR industry if a study like this — which drew on a fairly large number of respondents cutting across most hospital sizes and specialties — suggests that doctors are so unhappy with what they have. According to the report, the biggest physician frustrations are poor EMR usability and a lack of desired functionality, so what are we waiting for? Let’s get this right! The EMR revolution will never bear fruit if so many doctors are so frustrated with the tools they have.